Search

Aihaidan Abudouwayiti, Sureya Yisimayili, Ruzeguli Tuersun, Salamaiti Aimaier, Didaer Yisha, Xing Yan Zhang, Ying-Ying Zheng,&ast; Ailiman Mahemuti&ast; The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying-Ying Zheng; Ailiman Mahemuti, Cardiovascular Department of The First Affiliated Hospital of Xinjiang Medical University, 137 Carp Road, Xinshi District, Urumqi, 830054, Xinjiang, People’s Republic of China, Tel +86-15214804944 ; +86-13639970300, Email zhengying527@163.com; xinjiangailiman@163.comBackground: The role of high-density lipoprotein cholesterol (HDL-C) in heart failure (HF) outcomes is contentious. We aimed to assess HDL-C’s prognostic value in HF patients.Methods: In this retrospective cohort study (2012– 2022) at the First Affiliated Hospital of Xinjiang Medical University, we analyzed 4442 patients, categorized by HDL-C quartiles. We applied the Cox proportional hazards model to assess survival and report hazard ratios (HR) with 95% confidence intervals (CI).Results: Over a decade, we recorded 1354 fatalities (42.3%) and 820 readmissions. The third HDL-C quartile (0.93– 1.14 mmol/L) showed the lowest mortality rates, with reduced risks in the second and third quartiles compared to the first (Q2 HR=0.809, 95% CI 0.590– 1.109; Q3 HR=0.794, 95% CI 0.564– 1.118). The fourth quartile presented a lower mortality risk compared to the first (Q4 HR=0.887, 95% CI 0.693– 1.134). A significant correlation existed between HDL-C levels and cardiovascular risk (HR=0.85, 95% CI 0.75– 0.96, p< 0.01).Conclusion: HDL-C levels exhibit a complex association with mortality in HF, indicating the importance of HDL-C in HF prognosis and the need for tailored management strategies.Keywords: high-density lipoprotein cholesterol, heart failure, death, readmission, cardiovascular disease

Xin-Rong Yang,1 Xin-Yi Zhang,1 Yi-Jia Xia,1 Jin Fu,1 Xiao-Xuan Lian,2 Xin-Ru Liang,2 Ying-Qi He,2 Zhuo-Hong Li1 1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China; 2Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of ChinaCorrespondence: Zhuo-Hong Li, Email lizhuohong@cdutcm.edu.cnPurpose: Chemotherapy-induced peripheral neuropathy (CIPN) still lacks efficient therapeutic drugs. This study aimed to systematically evaluate the effects of Huangqi Guizhi Wuwu Decoction (HGWD) alone or combined with positive drugs on CIPN prevention and treatment.Methods: The PubMed, Embase, Web of Science, Cochrane, China National Knowledge Infrastructure (CNKI), Wan Fang Data, China Science and Technology Journal (VIP) and Chinese Biomedical (CBM) databases were searched for randomized controlled trials (RCTs) of HGWD for CIPN prevention and treatment. The search time ranged from database establishment to October 17, 2023. The Cochrane risk-of-bias assessment tool was used for quality assessment, Review Manager 5.3 and STATA 12.0 were used for meta-analysis, and GRADEprofiler was used for evidence level assessment.Results: A total of 32 RCTs involving 1987 patients were included. The meta-analysis results revealed the following: 1. In terms of the total CIPN incidence, that in the HGWD group was lower than that in the blank control group. The incidence in both the HGWD and HGWD+positive drug groups was lower than that in the monotherapy-positive drug group. 2. In terms of the incidence of severe CIPN, that in the HGWD group was lower than that in the blank control and positive drug groups. There was no statistically significant difference between the HGWD+positive drug and positive drug groups. Sensitivity analysis revealed that the results of severe incidence in the HGWD group was lower than that in the positive drug group were unstable 3. HGWD did not increase the number of chemotherapy-related adverse events.Conclusion: HGWD can safely and effectively prevent CIPN, reduce symptoms, improve quality of life and reduce the impact of chemotherapy drugs on sensory nerve conduction. However, more high-quality RCTs are needed to compare the efficacy of HGWD with that of positive control drugs in preventing severe CIPN.Keywords: huangqi guizhi wuwu decoction, chemotherapy-induced peripheral neuropathy, chemotherapy-induced peripheral neurotoxicity, Chinese medicine, meta-analysis

Meng-Die Cheng,1 Ying-Ying Zheng,2 Xing-Yan Zhang,2 Tuersun Ruzeguli,2 Yisimayili Sureya,2 Yisha Didaer,2 Mahemuti Ailiman,2 Jin-Ying Zhang1 1Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People’s Republic of China; 2Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, People’s Republic of ChinaCorrespondence: Jin-Ying Zhang, Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, No. 1, Jianshe Road, Zhengzhou, People’s Republic of China, Tel +86-0371- 67967641, Email jyzhang@zzu.edu.cn Ying-Ying Zheng, Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, No. 137, Liyushan Road, Urumqi, People’s Republic of China, Tel +86-0991-4361702, Email zhengying527@163.comBackground: The simplified thrombo-inflammatory score (sTIPS) has recently emerged as a novel prognostic score. Hence, we investigated the prognostic value of sTIPS for predicting long-term mortality in patients with heart failure (HF).Methods: A total of 3741 patients were analyzed in this study. The sTIPS was calculated based on the white blood cell count (WBC) and the mean platelet volume to platelet count (MPV/PC) ratio at admission. The mean follow-up time was 22.75 months. Multivariable Cox regression analyses were used to investigate the associations between the sTIPS and all-cause mortality (ACM).Results: In the whole study population, multivariate Cox regression analysis showed that patients in both the sTIPS 2 and sTIPS 1 groups had significantly increased risk of ACM as compared with patients in the sTIPS 0 group (hazard ratio [HR]=1.706, 95% confidence interval [CI]: 1.405– 2.072, P< 0.001 and HR = 1.431, 95% CI 1.270– 1.612, P< 0.001). The same significant trend was observed in heart failure with preserved ejection fraction (HFpEF) patients (sTIPS1 vs sTIPS0: HR = 1.366, 95% CI 1.100– 1.697, P = 0.005; sTIPS2 vs sTIPS0: HR = 1.995, 95% CI 1.460– 2.725, P< 0.001). However, only sTIPS 1 group had a significantly increased the risk of ACM compared to the sTIPS 0 group among patients with HFmrEF (sTIPS1 vs sTIPS0: HR = 1.648, 95% CI 1.238– 2.194, P = 0.001) and HFrEF (sTIPS1 vs sTIPS0: HR = 1.322, 95% CI 1.021– 1.712, P = 0.035).Conclusion: sTIPS is useful in predicting risk for long-term mortality in patients with HF.Keywords: simplified thrombo-inflammatory score, heart failure, prognosis, all-cause mortality

Abstract Collapse of the edge flow shear as the line-averaged density approaches the Greenwald density limit has been observed as a precursor to the enhanced edge particle flux characteristic of proximity to the density limit regime. Here, we report the use of a biased electrode to sustain the edge shear layer in high density discharges, in which the shear layer would otherwise collapse. A stable increase in line-averaged density is observed along with a strong increase in edge density. These experiments were carried out on the J-TEXT tokamak. The Reynolds stress at the edge is enhanced, and the zonal flow sustained, while density perturbation levels, the flux of turbulence internal energy (i.e., turbulence spreading), and particle and heat flux all decrease significantly. Electron adiabaticity increases, and bias voltage modulation experiments show that an increase in the edge shear leads the increase in adiabaticity. These results suggest that external edge E × B flow shear drive may be of interest for sustaining edge plasma states at high density, and support the hypothesis that collapse of the edge shear layer triggers the onset of the strong transport and turbulence characteristic of the density limit regime.

Enhanced particle transport events are discovered and analyzed as the density limit of the J-TEXT tokamak is approached. Edge shear layer collapse is observed and the ratio of Reynolds power to turbulence production decreases. Simultaneously, the divergence of turbulence internal energy flux (i.e. turbulence spreading) increases, indicating that shear layer collapse triggers an outward spreading event. Studies of correlations show that the enhanced particle transport events are quasi-coherent, and manifested primarily in density fluctuations which exhibit positive skewness. Electron adiabaticity emerges as the critical parameter which signals transport event onset. For α < 0.35 as density approaches the Greenwald density, both turbulence spreading and density fluctuations rise rapidly. Taken together, these results elucidate the connections between edge shear layer, density fluctuations, particle transport events, turbulence spreading and plasma edge cooling as the density limit is approached.

Nan Li,1 Wei-Xin Zhang,1 Yan-Yan Sun,1 Ting Li,1 Wei-Dan Cao,2 Qing-Hua Yang,3 Xin-Yao Zhang1 1School of Public Health, Jilin University, Changchun, People’s Republic of China; 2Edward R. Murrow College of Communication, Washington State University, Pullman, WA, USA; 3Bob Schieffer College of Communication, Texas Christian University, Fort Worth, TX, USACorrespondence: Xin-Yao Zhang, School of Public Health, Jilin University, 1163 Xinmin Street, Changchun, People’s Republic of China, Tel +86 13194352232, Email food@jlu.edu.cnBackground: Information seeking, as an important part of the prevention and control of infectious diseases, can lead to positive outcomes by reducing uncertainty and alleviating panic. However, most previous studies have limited their analysis to individual-level psychosocial factors, and little is known about how social-level factors influence individuals’ information-seeking intentions.Methods: The cross-sectional survey was conducted from July 30, 2020 to August 15, 2020 in China. We used a convenience sampling strategy to recruit participants from among the Internet users. The structural equation model was used to identify the incentives associated with coronavirus disease 2019 (COVID-19) risk information-seeking intention.Results: In this study, the responses of 871 Internet users who reflected a response rate of 85% were analyzed. Information-seeking intention was found to be directed by informational subjective norms (ISNs), perceived information need, risk knowledge, the sense of community (SOC), and negative affective responses, and ISNs were found to be the strongest driving factor. Individuals with a stronger SOC, which was associated with greater pressure and expectations, show negative affective responses. COVID-19 risk knowledge can affect the information-seeking intention of Internet users not only directly but also indirectly through their perceived information need. In addition, more risk knowledge was associated with a lower perceived risk likelihood.Conclusion: When formulating risk communication strategies, governments and health institutions should take targeted measures to improve the public’s SOC and knowledge. This will provide an opportunity to explore the role of individual cognition and environmental risk information in public health.Keywords: COVID-19, seeking intention, sense of community, internet user, planned risk information seeking model

Bing Tan, Qi-Yuan Yang, Bin Fan, Qin Li, Xiao-Yan Zhang Department of Spine Surgery, The Third Hospital of MianYang, Sichuan Mental Health Center, Mianyang, Sichuan Province, 621000, People’s Republic of ChinaCorrespondence: Qi-Yuan Yang, Department of Spine Surgery, The Third Hospital of MianYang, Sichuan Mental Health Center, Mianyang, Sichuan Province, 621000, People’s Republic of China, Tel +8615882889797, Email qiyuan5988@163.comPurpose: This study aimed to explore the effectiveness and safety of digital subtractionangiography (DSA)-guided percutaneous kyphoplasty (PKP) in treating multi-segmental osteoporotic vertebral compression fracture (OVCF).Methods: We retrospectively reviewed 68 patients with multi-segmental OVCF who had unilateral PKP surgeries using DSA and C arm guiding at our hospital between October 2016 and June 2020 and were followed for at least two years. All patients were divided into two groups: DSA guidance (n = 31) and C‐arm guidance (n=37). In addition, we collected the clinical and radiological evaluation results during postoperative and last follow-up periods.Results: Our findings revealed that the DSA guidance group required lesser time for channel establishment and surgery than the C-arm guidance group at P < 0.05. The incidences of bone cement leakage, fluoroscopy times, and radiation dose of the DSA guidance group were significantly lesser than the C‐arm guidance group (P < 0.05). Compared to the C-arm guidance group, the deviation of puncture in the DSA guidance group was significantly lower, the puncture angle in the DSA guidance group was significantly larger, and better bone cement distribution was obtained (P < 0.05). Compared to preoperative data, the VAS score, median vertebral height, and Cobb angle were significantly improved one day after surgery and the final follow-up in both groups (P < 0.05). However, the VAS score, the median vertebral height, average length of stay, and Cobb angle were not significantly different between the two groups (P > 0.05).Conclusion: DSA-guided PKP in treating multi-segmental OVCF can shorten the operation time, improve puncture accuracy, reduce the times and dose of fluoroscopy, reduce the leakage of bone cement, and achieve better cement distribution.Keywords: digital subtraction angiography, percutaneous kyphoplasty, multi-segmental osteoporotic vertebral compression fracture

Chenlu Huang,1,&ast; Weixia Li,2,&ast; Chong Chen,2,&ast; Wei Xu,1 Ling Fei,1 Shuai Tao,3 Qiankun Hu,1 Xudong Xie,1 Xiongyue Cao,1 Xiao-Yu Zhang,1,4 Liang Chen,1 Qiang Li,1 Yuxian Huang1 1Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China; 2Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China; 3Research Unit, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China; 4Section of Education, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuxian Huang; Qiang Li, Email yxhuang@fudan.edu.cn; liqiang66601@163.comAim: The early prognosis evaluation of acute-on-chronic liver failure (ACLF) is important to decrease its mortality. We aimed to develop a new score to accurately predict the outcome of patients with ACLF.Methods: A derivation set of 408 patients with hepatitis B virus-related ACLF (HBV-ACLF) based on the Asian Pacific Association for the Study of the Liver criteria is used to develop a prognostic score that was validated in 209 patients with HBV-ACLF and 195 patients with non-HBV-ACLF.Results: Seven factors were significantly related to the 28-day mortality and constituted a new score (CHINAT-CD4 = 0.320 × ln (creatinine) + 0.668 × hepatic encephalopathy score + 0.745 × ln (international normalized ratio) + 0.476 × ln (neutrophil) + 0.251 × ln (aspartate aminotransferase) + 0.411 × ln (total bilirubin) - 0.605 × ln (CD4+ T cells count)). The C-indices of the new score for the 28-/90-day mortality (0.810/0.806) outperformed those of the other seven scores (p≤ 0.05). The results were confirmed in a validation set (0.798/793 for HBV-ACLF; 0.790/0.788 for non-HBV-ACLF). The novel score based on CD4+ T cell count showed high predictive performance for the 28-/90-day mortality of ACLF.Conclusion: The novel score based on CD4+ T cell count can accurately predict the 28-/90-day mortality for patients with ACLF.Keywords: liver failure, chronic liver disease, prognostic score, risk stratification, inflammatory markers

Shun Yu Sun,1 Wei Yi Yang,2 Zhuo Tan,2 Xing Yu Zhang,1 Yi Lin Shen,1 Qi Wei Guo,1 Guo Ming Su,1 Xu Chen,1 Jia Lin,1 Ding Zhi Fang1 1Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, People’s Republic of China; 2Department of Preventive Medicine, West China School of Public health, Sichuan University, Chengdu, 610041, People’s Republic of ChinaCorrespondence: Ding Zhi FangDepartment of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, People’s Republic of China, Tel +86 28 85503410, Fax +86 28 85503204, Email dzfang@scu.edu.cnPurpose: To investigate serum levels of free fatty acids (FFAs) and their associations with routine serum lipids in diet-induced obese mice, which have been scantily reported before.Methods: Male C57BL/6 J mice were fed high-fat diets for 12 weeks to induce obesity. Levels of serum FFAs were measured by ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry.Results: Obese mice had higher serum levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), but lower triglycerides (TG) than control mice. A total of 30 FFAs were found, and 3 saturated fatty acids (SFAs), all 8 monounsaturated fatty acids (MUFAs) and 7 polyunsaturated fatty acids (PUFAs) decreased in obese mice, but one SFA (C4:0) increased. Differences in the relative levels of individual FFAs to total FFAs, SFAs, MUFAs or PUFAs between obese and control mice were different from each other and from those evaluated by concrete levels except C4:0, C16:1, C19:1 and C18:4. Only the concrete levels of C4:0, C22:3 and C18:4 were associated with routine serum lipids, including C22:3 negatively with TG in control mice, and C4:0 and C18:4 positively with LDL-C in obese mice, although the relative levels of C4:0 to total MUFAs negatively with TC, and C23:3 to total SFAs or MUFAs negatively with TG in control mice. Different relative levels of the remaining FFAs were differently associated with different routine serum lipids in obese and/or control mice.Conclusion: Obesity may influence serum FFAs profiles. The relationship of individual FFAs and their relative levels to other FFAs with routine serum lipids in obese and control mice suggests that individual FFAs may interact with others and obesity on levels of routine serum lipids. Once confirmed, the interactions may be novel perspectives when fatty acids are used to improve hyperlipidemia in the subjects with obesity.Keywords: free fatty acid, obesity, triglyceride, cholesterol, high-density lipoprotein, low-density lipoprotein

Xiao-Yu Zhang Section of Education, Shanghai Public Health Clinical Center, Fudan University; Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of ChinaCorrespondence: Xiao-Yu ZhangShanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of ChinaTel +86 130 52251333Email zhangxiaoyuPRC@163.comBackground: Public health is an important part of the national public safety system, and the establishment of a high-quality public health team with clinical knowledge and skills is increasingly valued, especially during pandemics of infectious diseases.Purpose: Rapid clinical promotion model of standardized training for public health physicians would be created for reference by other institutions or organizations.Data and Methods: The data related to the standardized training of public health physicians of Grade 2019 in Shanghai were collected and sorted out, which were summarized and analyzed by interview method, field investigation method, inductive reasoning, analogy reasoning and extreme reasoning method.Results: The rapid clinical promotion mode mainly included the following: the establishment of the management core, the definition of training objectives and implementation plans, the preparatory work in the early stage, the implementation of training missions for public health physicians, the building mechanism of tracking and feedback for clinical training, continuous follow-up and optimization of the clinical standardized training system, and the solution of key issues in clinical standardized training for public health physicians.Conclusion: The core of the model is the vertical management of a inter-disciplinary talent to plan and implement the affairs of standardized training for public health physicians comprehensively, as well as the timely intervention of key matters.Keywords: public health physicians, rapid clinical promotion model, standardized training

Xiao-Yu Zhang,1,* Tao Li,2,* Haibing Wu,3 Yun Ling,4 Zhi-Ping Qian,5 Liang Chen1 1Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China; 2Department of Tuberculosis Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China; 3Department of Neurosurgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China; 4Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China; 5Department of Severe Hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liang Chen; Xiao-Yu ZhangDepartment of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of ChinaTel +8618930810000; +8613052251333Email chenliang65@yeah.net; zhangxiaoyuPRC@163.comObjective: This study is to evaluate the effect of proton-pump inhibitors on the course of COVID-19.Methods: Clinical data of moderate COVID-19 patients admitted to the Shanghai Public Health Clinical Center for treatment from January 20, 2020, to March 16, 2020, were collected. A retrospective study was conducted and the patients were divided into two groups according to whether they used proton-pump inhibitors or not. The differences in SARS-CoV-2 clearance and hospital stay between the two groups were compared by Cox proportional hazards (PH) regression models and the propensity score matching method.Results: A total of 154 patients with moderate COVID-19 were included in this study, including 80 males (51.9%), 35 patients (22.7%) in the proton-pump inhibitor group, and 119 patients (77.3%) in the control group. In the proton-pump inhibitor group and the control group, the duration of the SARS-CoV-2 clearance was 7 days (95% CI, 6– 9) and 7 days (95% CI, 6– 11), and the duration of the hospital stay was 21 days (95% CI, 16– 25) and 20 days (95% CI, 15– 26), respectively. There was no significant difference between the both groups in the cumulative incidence of the SARS-CoV-2 clearance and the discharge, and the same results were obtained after the propensity score matching, all P > 0.05. There was no significant association between the use of proton-pump inhibitors and the duration of SARS-CoV-2 clearance, according to univariate analysis (HR, 1.309; 95% CI, 0.893– 1.918) and multivariate analysis (HR, 1.575; 95% CI, 0.993– 2.499). There was no significant association between the use of proton-pump inhibitors and the duration of hospital stay for COVID-19, according to univariate analysis (HR, 1.044; 95% CI, 0.714– 1.528) and multivariate analysis (HR, 1.064; 95% CI, 0.651– 1.740).Conclusion: The use of proton-pump inhibitors has no effect on prolonging or shortening the course of adults hospitalized with COVID-19.Keywords: COVID-19, SARS-CoV-2, proton-pump inhibitors, SARS-CoV-2 clearance, hospital stay

Chao Zhang, Jun Zhong, Wei-Xiang Chen, Xu-Yang Zhang, Yu-Hong Li, Teng-Yuan Zhou, Yong-Jie Zou, Chuan Lan, Lan Li, Zhao-Pan Lai, Hua Feng, Rong Hu Department of Neurosurgery and Key Laboratory of Neurotrauma, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, People’s Republic of ChinaCorrespondence: Rong Hu; Hua Feng Email huchrong@tmmu.edu.cn; fenghua8888@vip.163.comBackground: Inflammation plays an essential role in secondary brain injury after intracerebral hemorrhage (ICH). Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) have been suggested to suppress neuroinflammation after central nervous system (CNS) damage in animal models. However, the role of ACEIs and ARBs in ICH patients with hypertension remains unresolved in clinic. The aim of the present study is to evaluate the effect of ACEIs/ARBs on ICH patients with hypertension using a retrospective, single-center data analysis.Methods: ICH patients diagnosed by computerized tomographic (CT) at Southwest Hospital, Third Military Medical University were included in the present research from January 2015 to December 2019. According to the medical history for the usage of antihypertensive drugs, patients were assigned into either ACEIs/ARBs group or non-ACEIs/ARBs group. Demographics, clinical baseline, radiological documents and treatments were collected and these data were statistically analyzed between the two groups.Results: A total of 635 ICH patients with hypertension were included and allocated into 2 groups according to the usage of antihypertensive drugs: 281 in the ACEIs/ARBs group and 354 in the non-ACEIs/ARBs group. The results presented that the 3-months mortality and prevalence of ICH-associated pneumonia were lower in ACEIs/ARBs group than that in non-ACEIs/ARBs group (5.0% vs 11.9%, p=0.002; 58.4% vs 66.7%, p=0.031). While, there was no significant difference in favorable outcome (40.2% vs 33.9%, p=0.101) between the two groups. Furthermore, patients in ACEIs/ARBs group exhibited significantly less perihematomal edema volume on days 3 (23.5 ± 14.4 versus 28.7 ± 20.1 mL, p=0.045) and 7 (21.0 ± 13.7 versus 25.7 ± 17.6 mL, p=0.044), compared to that in non- ACEIs/ARBs group.Conclusion: The usage of ACEIs/ARBs helps decrease mortality, perihematomal edema volume, and prevalence of ICH-associated pneumonia in ICH patients with hypertension.Keywords: angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, inflammation, intracerebral hemorrhage, ICH-associated pneumonia

Xiao-Yu Zhang,1,* Lin Zhang,2,3,* Yang Zhao,3,4 Liang Chen1 1Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, People’s Republic of China; 2School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, People’s Republic of China; 3Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3100, Australia; 4WHO Collaborating Centre on Implementation Research for Prevention & Control of NCDs, Melbourne, Victoria 3100, Australia*These authors contributed equally to this workCorrespondence: Liang ChenShanghai Public Health Clinical Center, Fudan University, Shanghai 201508, People’s Republic of ChinaEmail chenliang65@yeah.netPurpose: This study is to investigate the risk prediction of severe or critical events of COVID-19 in older adults in China and provide the evidence to support the management of older adults with COVID-19.Materials and Methods: The clinical data of older adults with COVID-19 admitted to the Shanghai Public Health Clinical Center during January 20, 2020 to March 16, 2020 were collected. The possible risk factors of severe or critical illness were investigated with Cox proportional hazards (PH) regression models for univariate and multivariate analyses to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). For the prediction indicators, optimum cut-off points were determined by calculating Youden’s index. The efficacy of risk prediction of severe or critical illness was examined through the receiver operating characteristic (ROC) curve.Results: A total of 110 older adults with COVID-19 were included, in which 21 (19.1%) patients had severe or critical illness of COVID-19. Multivariable regression analysis showed that CD4 cells and D-dimer were independent risk factors. D-dimer, CD4 cells, and CD cells/D-dimer ratio with cut-off values of 0.65 (mg/L), 268 (cell/μL) and 431 were in the prediction of severe or critical illness of older adults with COVID-19. The AUC value of D-dimer, CD4 cells, CD4 cells/D-dimer ratio, the tandem combination and the parallel combination to predict severe or critical illness of the older adults with COVID-19 were 0.703, 0.804, 0.794, 0.812 and 0.694, respectively.Conclusion: D-dimer and CD4 cells either by themselves or in combination have demonstrated predictive value in risk stratification as well as established the prognosis of severe or critical illness in older adults with COVID-19.Keywords: COVID-19, SARS-CoV-2, older adults, risk assessment, risk prediction

Hui Zhang,1 Xiao-Yu Zhang,1 Xiao-Ning Kang,2 Li-Jun Jin,1 Zun-Yi Wang1 1Department of Thyroid and Breast III, Cangzhou Central Hospital, Cangzhou, Hebei 061001, People’s Republic of China; 2Department of Ultrasound, Cangzhou Central Hospital, Cangzhou, Hebei 061001, People’s Republic of ChinaCorrespondence: Zun-Yi WangDepartment of Thyroid and Breast III, Cangzhou Central Hospital, Cangzhou, Hebei 061001, People’s Republic of ChinaEmail wangzunyi890@163.comBackground: Clinical tolerance to trastuzumab greatly affects the therapeutic effect in breast cancer (BC). Long-chain non-coding RNA (lncRNA) plays an important role in the development of trastuzumab resistance, in which SNHG7 can promote the epithelial mesenchymal transformation (EMT) of breast cancer cells into, while EMT is related to trastuzumab resistance of breast cancer cells.Objective: To investigate whether lncRNA-SNHG7 can enhance chemotherapy resistance and cell viability of BC cells by regulating miR-186.Methods: SK-BR-3 and SNHG7 of HER2+BC cells were induced to enhance the resistance of BC cells to trastuzumab by regulating miR-186, and to regulate the expression levels of SNHG7 and miR-186. The sensitivity of drug-resistant cells to trastuzumab and the changes of cell proliferation, migration, apoptosis, and EMT were measured and verified by tumorigenesis in vivo. The effects of miR-186 on SNHG7 were investigated through rescue experiments; the regulatory relationship between the expression of SNHG7 and miR-186 was verified by the double luciferase reporter (DLR) and the mechanism of SNHG7 was explored.Results: Down-regulation of SNHG7 or up-regulation of miR-186 could increase the sensitivity of BC cells to trastuzumab, inhibit the proliferation, migration and EMT, and promote apoptosis. Compared with the down-regulation of SNHG7 or miR-186 alone, simultaneous down-regulation of SNHG7 and miR-186 on drug-resistant cells brought notably lower sensitivity to trastuzumab and apoptosis rate, and higher proliferation and apoptosis ability. The DLR showed that miR-186 could specifically inhibit the expression of SNHG7. The results of tumorigenesis in vivo revealed that down-regulation of SNHG7 or up-regulation of miR-186 could improve the therapeutic effect of trastuzumab and reduce the tumor volume, and miR-186 could also antagonize the effect of SNHG7.Conclusion: Down-regulation of SNHG7-targeted miR-186 can reverse trastuzumab resistance of BC cells, inhibit the proliferation, migration, and EMT levels of BC cells, and promote apoptosis.Keywords: SNHG7, miR-186, breast cancer, drug resistance

Si-Man Cai,1 Hong-Yan Wang,1 Xiao-Yan Zhang,1 Li Zhang,1 Qing-Li Zhu,1 Jian-Chu Li,1 Qiang Sun,2 Yu-Xin Jiang1 1Department of Medical Ultrasound, Peking Union Medical College Hospital and Chinese Academy Medical Sciences, Beijing 100730, People’s Republic of China; 2Department of Breast Surgery, Peking Union Medical College Hospital and Chinese Academy Medical Sciences, Beijing 100730, People’s Republic of ChinaCorrespondence: Hong-Yan WangDepartment of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy Medical Sciences, N0.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, People’s Republic of ChinaTel/Fax +86 10-69155494Email whychina@126.comPurpose: To investigate whether the vascular index (VI) of superb microvascular imaging (SMI) could improve the diagnostic efficiency for BI-RADS 4 breast lesions and reduce the number of unnecessary biopsies.Patients and Methods: For this study, we selected 222 consecutive BI-RADS 4 breast lesions detected by ultrasound and confirmed by pathology from January 2016 to October 2018. A VI of 4.0 was set as the cutoff value to degrade BI-RADS classification. We calculated the accuracy, sensitivity and PPV of a BI-RADS diagnosis alone and the combination of BI-RADS and the VI.Results: Pathologically, of the 222 lesions, 129 were confirmed to be benign, and 93 were found to be malignant. A VI of 4.0 was set as the cutoff value; when the VI≤ 4.0, those BI-RADS 4 masses were downgraded one level (4C-4B, 4B-4A, 4A-3) to an integral BI-RADS grade, while the others maintained the conventional grade. A total of 54 BI-RADS 4 lesions were degraded to BI-RADS 3, including 53 benign lesions and 1 malignant lesion. The diagnostic accuracy (65.3% vs 41.9%) and PPV (54.8% vs 41.9%) were significantly improved. The sensitivity decreased slightly (98.9% vs 100%) because 1 of the 54 downgraded BI-RADS 4 lesions, which had a pathological type of invasive ductal carcinoma, was incorrectly downgraded.Conclusion: SMI is a noninvasive tool for visualizing the vascular structure with high-resolution microvascular images. As a quantitative index, the VI can be used to appropriately downgrade benign lesions classified as BI-RADS 4, which can improve the diagnostic accuracy and PPV and reduce unnecessary biopsies.Keywords: superb microvascular imaging, breast neoplasms, ultrasonography, diagnostic imaging

Xiao-Yan Zhang,1 Li Zhang,1 Na Li,1 Qing-Li Zhu,1 Jian-Chu Li,1 Qiang Sun,2 Hong-Yan Wang1,* Yu-Xin Jiang1,*1Department of Diagnostic Ultrasound, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China; 2Department of Breast Surgery, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, People’s Republic of China*These authors contributed equally to this work Purpose: The purpose of our study was to prospectively evaluate the diagnostic performance of the vascular index (VI, defined as the ratio of Doppler signal pixels to pixels in the total lesion) measured via Smart 3-D superb microvascular imaging (SMI) for breast lesions.Patients and methods: Two hundred and thirty-two consecutive patients with 236 breast lesions referred for biopsy at Peking Union Medical College Hospital were enrolled in the study from December 2016 to November 2017. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of VI were calculated with histopathologic results as the reference standard.Results: Of the 236 breast lesions, 121 were malignant and 115 were benign. The mean VI was significantly higher in malignant lesions (9.7±8.2) than that in benign ones (3.4±3.3) (P

Wei Zheng,1 Xin-Ni Luo,1 Hai-Yan Li,1 Xiao-Yin Ke,1 Qing Dai,1 Chan-Juan Zhang,1 Xiang-Yang Zhang,1,2 Yu-Ping Ning1 1The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; 2Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA Background: Region-specific differences in the prevalence of insomnia symptoms in outpatient clinics in China have received little systematic study. This study was conducted preliminarily to examine region-specific differences in the risk of insomnia symptoms in Chinese outpatients. Method: In total, 4,399 adult outpatients (urban vs rural residents: 1,768 vs 2,631) who completed three questions focusing on insomnia symptoms were included. Their sociodemographic and clinical information were collected with standardized questionnaires. Results: The prevalence of self-reported insomnia symptoms in urban residents (23.4%) was more frequent than the prevalence in rural residents (21.2%). The estimated prevalence of insomnia symptoms was significantly lower in rural than urban residents after adjusting for the potential confounders (P=0.015). Similarly, more urban (22.9%) than rural (13.4%) residents with insomnia symptoms had significantly higher treatment rates (χ2=14.9, P

Yishun Yang,1 Yuan Zhao,2 Jinshuai Lan,1 Yanan Kang,3 Tong Zhang,1 Yue Ding,1 Xinyu Zhang,1 Lu Lu3 1Experiment Centre of Teaching and Learning, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 2Experiment Centre for Science and Technology, Shanghai University of Traditional Chinese Medicine, Shanghai, China; 3School of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China Introduction: A reduction-sensitive CD44-positive tumor-targetable drug delivery system for doxorubicin (DOX) delivery was developed based on hyaluronic acid (HA)-grafted polymers. Materials and methods: HA was conjugated with folic acid (FA) via a reduction-sensitive disulfide linkage to form an amphiphilic polymer (HA-ss-FA). The chemical structure of HA-ss-FA was analyzed by ultraviolet spectroscopy, Fourier transform infrared spectroscopy, and 1H nuclear magnetic resonance (NMR) spectroscopy. The molecular weight of HA-ss-FA was determined by high-performance gel permeation chromatography. Blank HA-ss-FA micelles and DOX-loaded micelles were prepared and characterized. The reduction responsibility, cellular uptake, and in vivo biodistribution of HA-ss-FA micelles were investigated. Results: DOX-loaded micelles were of high encapsulation efficiency (88.09%), high drug-loading content (22.70%), appropriate mean diameter (100–120 nm), narrow size distribution, and negative zeta potential (-6.7 to -31.5 mV). The DOX release from the micelles was significantly enhanced in reduction environment compared to normal environment. The result of in vitro cytotoxicity assay indicated that the blank micelles were of low toxicity and good biocompatibility and the cell viabilities were >100% with the concentration of HA-ss-FA from 18.75 to 600.00 µg/mL. Cellular uptake and in vivo biodistribution studies showed that DOX-loaded micelles were tumor-targetable and could significantly enhance cellular uptake by CD44 receptor-mediated endocytosis, and the cellular uptake of DOX in CD44-positve A549 cells was 1.6-fold more than that in CD44-negative L02 cells. In vivo biodistribution of HA-ss-FA micelles showed that micelles were of good in vivo tumor targetability and the fluorescence of indocyanine green (ICG)-loaded micelles was 4- to 6.6-fold stronger than free ICG within 6 h in HCCLM3 tumor-bearing nude mice. Conclusion: HA-ss-FA is a promising nanocarrier with excellent biocompatibility, tumor targetability, and controlled drug release capability for delivery of chemotherapy drugs in cancer therapy. Keywords: hyaluronic acid, CD44 receptor targeting, redox responsive, folic acid, micelles, doxorubicin

Xuyang Zhang,1 Hao Wang,1 Jonathan Andrew Coulter,2 Ruijie Yang1 1Department of Radiation Oncology, Peking University Third Hospital, Beijing, China; 2School of Pharmacy, Queen’s University of Belfast, Belfast, UK Background: This study investigated the effectiveness and underpinning mechanisms of radiosensitization using octaarginine (R8)-modified gold nanoparticle–poly(ethylene glycol) (GNP-PEG-R8) in colorectal cancer cell line LS180 to megavoltage radiotherapy in vitro. Method: In-house synthesized GNP-PEG was characterized by transmission electron micro­scopy, dynamic light scattering, ultraviolet–visible spectrophotometry, and X-ray photoelectron spectroscopy. Inductively coupled plasma mass spectroscopy was used to quantify internalization. Direct cytotoxicity was established using the Cell Counting Kit-8, while radiosensitivity was determined using the gold standard in vitro clonogenic assay. Cell-cycle distribution, apoptosis, reactive oxygen species (ROS), and mitochondrial membrane potential (MMP) were analyzed by flow cytometry, further exploring the key mechanisms driving GNP-PEG-R8 radiosensitization. Results: The core GNP diameter was 6.3±1.1 nm (mean±SD). Following functionalization, the hydrodynamic diameter increased to 19.7±2.8 nm and 27.8±1.8 nm for GNP-PEG and GNP-PEG-R8, with respective surface plasmon resonance peaks of 515 nm and 525 nm. Furthermore, incorporation of the R8 significantly increased nanoparticle internalization compared to GNP-PEG (p

Jianhui Wu,1–4 Ming Zhao,1–5 Yuji Wang,1–4 Yaonan Wang,1–4 Haimei Zhu,1–4 Shurui Zhao,1–4 Lin Gui,1–4 Xiaoyi Zhang,1–4 Shiqi Peng1–4 1Beijing Area Major Laboratory of Peptide and Small Molecular Drugs, 2Engineering Research Center of Endogenous Prophylactic, Ministry of Education of China, 3Beijing Laboratory of Biomedical Materials, 4College of Pharmaceutical Sciences, Capital Medical University, Beijing, People’s Republic of China; 5Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China Abstract: It is well documented that the surfaces of cancer cells, activated platelets and inflammatory cells are rich in P-selectin. N-(3-hydroxymethyl-β-carboline-1-yl-ethyl-2-yl)-l-Phe (HMCEF) is a P-selectin inhibitor capable of simultaneously inhibiting thrombosis and inflammation. Based on the knowledge that P-selectin is a common target for antithrombotic, anti-inflammatory and antitumor drugs, the aim of this study article was to estimate the possibility of HMCEF as a nanoscaled antitumor drug. Images of transmission electron micro­scopy, scanning electron microscopy and atomic force microscopy proved that HMCEF forms nanoparticles with a diameter of

Hufei Zhang,1,* Xinhe Liu,2,* Hongye Jiang,3 Zimeng Liu,4 Xu-Yu Zhang,1 Hong-Zhe Xie,3 1Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 2Department of Anesthesiology, Shenzhen Hospital, University of Hong Kong, Shenzhen, 3Department of Obstetrics and Gynecology, 4Surgical Intensive Care Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China *These authors contributed equally to this work Objectives: Postlaparoscopic shoulder pain (PLSP) remains a common problem after laparoscopies. The aim of this study was to investigate the correlation between pressure pain threshold (PPT) of different muscles and PLSP after gynecologic laparoscopy, and to explore the effect of parecoxib, a cyclooxygenase-2 inhibitor, on the changes of PPT.Materials and methods: The patients were randomly allocated into two groups; group P and group C. In group P, parecoxib 40 mg was intravenously infused at 30 minutes before surgery and 8 and 20 hours after surgery. In group C, normal saline was infused at the corresponding time point. PPT assessment was performed 1 day before surgery and at postoperative 24 hours by using a pressure algometer at bilateral shoulder muscles (levator scapulae and supraspinatus) and forearm (flexor carpi ulnaris). Meanwhile, bilateral shoulder pain was evaluated through visual analog scale score at 24 hours after surgery. Results: Preoperative PPT level of the shoulder, but not of the forearm, was significantly and negatively correlated with the intensity of ipsilateral PLSP. In group C, PPT levels of shoulder muscles, but not of forearm muscles, decreased after laparoscopy at postoperative 24 hours. The use of parecoxib significantly improved the decline of PPT levels of bilateral shoulder muscles (all P

Li-Yao Zhu,1,* Yu-Gang Wang,2,* Li-Qing Wei,3,* Jian Zhou,1 Wei-Jie Dai,4 Xiao-Yu Zhang5,6 1Department of Hepatology, The Fourth People’s Hospital of Huai’an, Huai’an, Jiangsu, 2Department of Gastroenterology, Shanghai Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 3Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 4Department of Gastroenterology, Huai’an First People’s Hospital, Nanjing Medical University, 5Division of Gastrointestinal Surgery, Department of General Surgery, The Affiliated Huai’an Hospital of Xuzhou Medical College, 6Division of Gastrointestinal Surgery, Department of General Surgery, The Second People’s Hospital of Huai’an, Huai’an, Jiangsu, People’s Republic of China *These authors contributed equally to this work Purpose: To further observe and verify the effect of nonalcoholic fatty liver disease (NAFLD) on the response to antiviral therapy in patients with chronic hepatitis B (CHB) and investigate the relationship between the virologic response and insulin resistance. Patients and methods: A retrospective study was adopted and 61 NAFLD patients with HBeAg-positive CHB were included as the observation group (group A), and 64 patients with simple CHB were included as the control group (group B). Results: After 12 weeks of treatment with entecavir, the total virologic response rate in group A was statistically significantly lower than that in group B (P0.05). In weeks 48 and 96, there was no significant difference in the HBeAg seroconversion rates between the two groups (P>0.05). In weeks 12 and 24, there was also no significant difference in the alanine transaminase (ALT) normalization rate between the two groups (P>0.05). Then, in weeks 48 and 96, the ALT normalization rate of group A was obviously lower than that of group B (PM) according to the median value (M=2.79) of the baseline homeostatic model assessment method insulin resistance levels. In weeks 48 and 96, the ALT normalization rate of group A1 was significantly higher than that of group A2 (P

Yong-Hui Ding,1,2 Zhi-Wei Zhou,2,3 Chun-Fang Ha,1 Xue-Yu Zhang,1 Shu-Ting Pan,4 Zhi-Xu He,3 Jeffrey L Edelman,2 Dong Wang,5 Yin-Xue Yang,6 Xueji Zhang,7 Wei Duan,8 Tianxin Yang,9 Jia-Xuan Qiu,4 Shu-Feng Zhou2,3 1Department of Gynecology, General Hospital of Ningxia Medical University, Yinchuan, People’s Republic of China; 2Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA ; 3Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, 4Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 5Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, 6Department of Colorectal Surgery, General Hospital of Ningxia Medical University, Yinchuan, 7Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing, People’s Republic of China; 8School of Medicine, Deakin University, Waurn Ponds, Australia; 9Department of Internal Medicine, University of Utah and Salt Lake Veterans Affairs Medical Center, Salt Lake City, UT, USA Abstract: Ovarian cancer is a leading killer of women, and no cure for advanced ovarian cancer is available. Alisertib (ALS), a selective Aurora kinase A (AURKA) inhibitor, has shown potent anticancer effects, and is under clinical investigation for the treatment of advanced solid tumor and hematologic malignancies. However, the role of ALS in the treatment of ovarian cancer remains unclear. This study investigated the effects of ALS on cell growth, apoptosis, autophagy, and epithelial to mesenchymal transition (EMT), and the underlying mechanisms in human epithelial ovarian cancer SKOV3 and OVCAR4 cells. Our docking study showed that ALS, MLN8054, and VX-680 preferentially bound to AURKA over AURKB via hydrogen bond formation, charge interaction, and π-π stacking. ALS had potent growth-inhibitory, proapoptotic, proautophagic, and EMT-inhibitory effects on SKOV3 and OVCAR4 cells. ALS arrested SKOV3 and OVCAR4 cells in G2/M phase and induced mitochondria-mediated apoptosis and autophagy in both SKOV3 and OVCAR4 cell lines in a concentration-dependent manner. ALS suppressed phosphatidylinositol 3-kinase/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and p38 mitogen-activated protein kinase pathways but activated 5′-AMP-dependent kinase, as indicated by their altered phosphorylation, contributing to the proautophagic activity of ALS. Modulation of autophagy altered basal and ALS-induced apoptosis in SKOV3 and OVCAR4 cells. Further, ALS suppressed the EMT-like phenotype in both cell lines by restoring the balance between E-cadherin and N-cadherin. ALS downregulated sirtuin 1 and pre-B cell colony enhancing factor (PBEF/visfatin) expression levels and inhibited phosphorylation of AURKA in both cell lines. These findings indicate that ALS blocks the cell cycle by G2/M phase arrest and promotes cellular apoptosis and autophagy, but inhibits EMT via phosphatidylinositol 3-kinase/Akt/mTOR-mediated and sirtuin 1-mediated pathways in human epithelial ovarian cancer cells. Further studies are warranted to validate the efficacy and safety of ALS in the treatment of ovarian cancer. Keywords: alisertib, Aurora kinase A, epithelial ovarian cancer, cell cycle, apoptosis, autophagy, epithelial to mesenchymal transition, sirtuin 1

Bo Li,1,2 Xiao-Yong Zhang,1 Jian-Zhong Yang,1 Yu-Jie Zhang,1 Wen-Xin Li,1 Chun-Hai Fan,1 Qing Huang1 1Laboratory of Physical Biology, Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai, 2Department of Human Anatomy, College of Basic Medical Sciences, Jilin University, Changchun, People’s Republic of China Abstract: In this study, we assessed the in vivo behavior and toxicology of nanoscale graphene oxide (NGO) in mice after intravenous injection. The influence of a polyethylene glycol (PEG) coating on the distribution and toxicity of the NGO was also investigated. The results show that NGO is mainly retained in the liver, lung, and spleen. Retention in the lung is partially due to NGO aggregation. The PEG coating reduces the retention of NGO in the liver, lung, and spleen and promotes the clearance of NGO from these organs, but NGO and NGO-PEG are still present after 3 months. The PEG coating effectively reduces the early weight loss caused by NGO and alleviates NGO-induced acute tissue injuries, which can include damage to the liver, lung, and kidney, and chronic hepatic and lung fibrosis. Keywords: graphene oxide, biodistribution, toxicity, polyethylene glycol

Kai Zhao,1,2,* Yang Zhang,1,2,* Xiaoyan Zhang,1,* Wei Li,1 Ci Shi,1,2 Chen Guo,1 Chunxiao Dai,3 Qian Chen,1 Zheng Jin,3 Yan Zhao,2 Hongyu Cui,2 Yunfeng Wang2 1College of Life Science, Heilongjiang University, 2Division of Avian Infectious Diseases, State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, 3Key Laboratory of Chemical Engineering Process and Technology for High-Efficiency Conversion, Heilongjiang University, Harbin, People's Republic of China *These authors contributed equally to this work Abstract: Optimal preparation conditions of Newcastle disease virus (NDV) F gene deoxyribonucleic acid (DNA) vaccine encapsulated in chitosan nanoparticles (pFNDV-CS-NPs) were determined. The pFNDV-CS-NPs were prepared according to a complex coacervation method. The pFNDV-CS-NPs were produced with good morphology, high stability, a mean diameter of 199.5 nm, encapsulation efficiency of 98.37%±0.87%, loading capacity of 36.12%±0.19%, and a zeta potential of +12.11 mV. The in vitro release assay showed that the plasmid DNA was sustainably released from the pFNDV-CS-NPs, up to 82.9%±2.9% of the total amount. Cell transfection test indicated that the vaccine expressed the F gene in cells and maintained good bioactivity. Additionally, the safety of mucosal immunity delivery system of the pFNDV-CS-NPs was also tested in vitro by cell cytotoxicity and in vivo by safety test in chickens. In vivo immunization showed that better immune responses of specific pathogen-free chickens immunized with the pFNDV-CS-NPs were induced, and prolonged release of the plasmid DNA was achieved compared to the chickens immunized with the control plasmid. This study lays the foundation for the further development of mucosal vaccines and drugs encapsulated in chitosan nanoparticles. Keywords: Newcastle disease, DNA vaccine, chitosan nanoparticles, mucosal immunity delivery system, immune effectiveness

Cai-Hong Hua, Hui-Min Guo, Xin-Lei Guan, Fan-Jing Kong, Rui-Jie Hou, Xue-Ying Zhang, Shao-Ru Li Department of Gynecology and Obstetrics, First Affiliated Hospital of Xinxiang Medical University, Weihui City, Henan Province, People’s Republic of China Purpose: The aim of our study was to assess, for the first time, the validity, reliability, and acceptability of the European Organization for Research and Treatment of Cancer (EORTC) Quality Of Life questionnaire (QLQ) cervical cancer module (CX24) in Chinese cervical cancer patients. Patients and methods: One hundred fifteen outpatients with cervical cancer in the First Affiliated Hospital of Xinxiang Medical University from May 2013 to July 2013 were included in this study. All participants self-administered the EORTC QLQ-CX24 and the core questionnaire (EORTC QLQ-C30), and the Karnofsky Performance Scale was performed to evaluate scores. Data were analyzed with Cronbach’s α coefficient, Pearson correlation test, multitrait scaling analysis, and Mann–Whitney U test. Results: Scale reliability was confirmed by Cronbach’s α coefficients for internal consistency, which ranged from 0.71 to 0.82. Convergent and discriminant validity were confirmed by multitrait scaling analysis, which revealed three (3.4%) scaling errors for symptom experience scales and zero (0%) for body image as well as sexual/vaginal functioning scales. Higher missing value rate occurred in sexuality-related items. The clinical validity of the Chinese version of the EORTC QLQ-CX24 was demonstrated by the ability to discriminate among patients in different International Federation of Gynecology and Obstetrics stages. Conclusion: The EORTC QLQ-CX24 was proved to be a reliable and valid instrument with which to measure the quality of life in cervical cancer patients in the People’s Republic of China. Keywords: cervical cancer, quality of life, EORTC QLQ-CX24, People’s Republic of China